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SanclementeG_BMC_Nephrol_2019.pdf (621.82 KB)

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2019-07-22

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cc by (c) Sanclemente et al., 2019
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/138983

Perioperative prophylaxis with ertapenem reduced infections caused by extended-spectrum betalactamase-producting Enterobacteriaceae after kidney transplantation

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Recurs relacionat

http://dx.doi.org/10.1186/s12882-019-1461-4

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Backgound: In recent years we have witnessed an increase in infections due to multidrug-resistant organisms in kidney transplant recipients (KTR). In our setting, we have observed a dramatic increase in infections caused by extended-spectrum betalactamase-producing (ESBL) Enterobacteriaceae in KTR. In 2014 we changed surgical prophylaxis from Cefazolin 2 g to Ertapenem 1 g. Methods: We compared bacterial infections and their resistance phenotype during the first post-transplant month with an historical cohort collected during 2013 that had received Cefazolin. Results: During the study period 110 patients received prophylaxis with Cefazolin and 113 with Ertapenem. In the Ertapenem cohort we observed a non-statistically significant decrease in the percentage of early bacterial infection from 57 to 47%, with urine being the most frequent source in both. The frequency of infections caused by Enterobacteriaceae spp. decreased from 64% in the Cefazolin cohort to 36% in the Ertapenem cohort (p = 0.005). In addition, percentage of ESBL-producing strains decreased from 21 to 8% of all Enterobacteriaceae isolated (p = 0.015). After adjusted in multivariate Cox regression analysis, male sex (HR 0.16, 95%CI: 0.03–0.75), cefazolin prophylaxis (HR 4.7, 95% CI: 1.1–22.6) and acute rejection (HR 14.5, 95% CI: 1.3–162) were associated to ESBL- producing Enterobacteriaceae infection. Conclusions: Perioperative antimicrobial prophylaxis with a single dose of Ertapenem in kidney transplant recipients reduced the incidence of early infections due to ESBL-producing Enterobacteriaceae without increasing the incidence of other multidrug-resistant microorganisms or C. difficile.

Matèries

Trasplantament renal, Enterobacteriàcies

Matèries (anglès)

Kidney transplantation, Enterobacteriaceae

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Col·leccions

Articles publicats en revistes (Medicina)
Articles publicats en revistes (Fonaments Clínics)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)
Articles publicats en revistes (ISGlobal)

Citació

SANCLEMENTE, Gemma, BODRO, Marta, CERVERA, Carlos, LINARES, Laura, COFÁN PUJOL, Federico, MARCO REVERTÉ, Francesc, BOSCH MESTRES, Jordi, OPPENHEIMER SALINAS, Federico, DIECKMANN, Fritz, MORENO CAMACHO, Ma. asunción. Perioperative prophylaxis with ertapenem reduced infections caused by extended-spectrum betalactamase-producting Enterobacteriaceae after kidney transplantation. _BMC Nephrology_. 2019. Vol. 20. [consulta: 28 de gener de 2026]. ISSN: 1471-2369. [Disponible a: https://hdl.handle.net/2445/138983]

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